BLS and PRAPID Flashcards
Why are Children at higher risk of airway obstruction?
Obligate nasal breathers until 6/12
Tongue proportionally big to mouth
Short neck
Responding to airway compromise
Older= Head tilt and chin lift +/- Jaw thrust
<1 year= Neutral position +/- Jaw thrust
OPA or NPA
What pathology is a CI to an airway adjunct?
Basal Skull Fracture
RR of an infant
30-40
RR of 5-12 year olds
20-25
What positions suggest cerebral compromise
Decorticate or Deceberate
How do you quickly assess dehydration?
Fontanelle
CRT
Eyes
Mucous Membranes
Fluid bolus given in an acutely shocked child?
20mls/kg/hr 0.9% NaCl
Assess response +/- 2nd bolus
Cushing’s response indicating raised ICP
Bradycardia
HTN
Tachypnoea
When would you treat hypoglycaemia?
Blood glucose <4mmol/L
Treat with 2-3mg 10% Glucose
Likely cause of cardiac arrest in children
Hypoxia
3 S’s of BLS
Safety
Stimulate
Shout for Help
Interventions in BLS
Open Airway
5 Rescue breaths each 1s long
15:2 chest compressions especially if HR<60
Help
Ratio of chest compressions to breaths
15:2
Do 3:1 in newborn
Agonal breathing
Irregular gasping few minutes post-cardiac arrest therefore…
5 RB then 15:2
Management of choking with an ineffective cough
If unconscious then open airway do 5 breaths and start CPR
If conscious then 5 back blows, 5 thrusts
Single finger sweep allowed
HEAD DOWN
Back blows and thrust location in different ages
> 1 year then do abdo
<1 year then do chest
Management of choking with effective cough
Encourage cough
Check for deterioration to ineffective cough
Ineffective vs Effective cough
Ineffective- Cannot vocalise, quiet and silent
Effective- Crying, verbal response, able to take breath before coughing
Anaphylaxis
IgE mediated T1 HSN reaction
Increased bronchial secretions and SM tone
Increased capillary permeability
Decreased Vascular SM tone
Dose of adrenaline in Anaphylaxis
1: 1000 0.5ml if 12+ IM in thigh
0. 3ml if 6-12 and 0.15 if <6
Can repeat after 5 mins
What PAWS score indicates need for Urgent review
> 10
6-9 is hourly obs and Dr review
Management of Status Epilepticus
1) Iv lorazepam 0.1mg/kg ir 0.5mg/kg Bucc Mid or Rec Diaz
Repeat after 10 mins max 2 doses
2) Start this step 20 mins after start IV phenytoin 20mg/kg IV over 20 mins (Alt= Phenobarbital)
3) RSI with thiopentone
Clinical dehydration vs shock vs late decompensated shock
Clinical dehydration= HR/RR inc, Decreased skin turgor, Decreased UO
Shock= Above + Pale, Cold, Prolonged CRT, Consciousness decreased
Decompensated= Hypotension, Bradycardia, Kussmal breathing, Blue, No UO
4 types of shock
Hypovolaemic
Distributive
Cardiogenic
Obstructive
Obstructive shock
Tension Pneumothorax
Cardiac Tamponade
Causes of distributive shock
Anaphylaxis
Brain injury
Hypovolaemic shock
Gastroenteritis, DKA, Bowel obstruction, Haemorrhage
What HR is a typical indicating for chest compressions during BLS
<60bpm
